As stated in the previous paper, the chosen topic for the study is “Quality Health Care Access for the Impoverished under the Health Care Reform System.” The research question is: Can quality health care be accessed for the impoverished under the health care reform system? The general problem at hand primarily involves two things: the nature of change in healthcare and the direction of change (which can either be positive or negative) (Hannerman et al., 2013). Current literature suggests that the changes attributable to the functioning of quality managed care organizations may be more negative than positive, with a measurable deterioration in the quality of care delivered to patients (Zwanziger & Melnick, 2007).